Disorders of the Gastrointestinal System, 2nd Edition
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DISORDERS OF THE LOWER GI SYSTEM
Nursing considerations for Crohn’s dis- ease include the following (Ghazi, 2019): ● Meticulously monitor intake and output. ● Monitor for fluid and electrolyte imbalances. ● Monitor hemoglobin and hematocrit levels. ● Promote rest and avoidance of foods that trigger attacks. ● For patients requiring a resection with stoma creation, arrange an enterostomal therapist or nurse visit for preoperative site marking and education (Wound, Ostomy, and Continence Nurses Society [WOCN Society], 2021); postoperative education and emotional support are critical for an effective recovery. ● Provide emotional support as patients deal with the effects of Crohn’s disease and its chronic nature (Crohn’s & Colitis Foundation, 2022). There are many other types of IBD be- sides Crohn’s and ulcerative colitis, so extensive diagnostic testing may be re- quired.
Colorectal cancer CASE STUDY 10
James is a 55-year-old African American machinist who works 40 or more hours per week. He smokes about a pack of cigarettes a day. James recently noticed some dull abdominal pain and that his stools were thin and ribbon-like. He has been extremely tired and hasn’t had much of an appetite, but he believes that this is because of stress and chooses to ignore his symptoms. Over several months, the symptoms continue to get worse. He is feeling run down, losing weight, and no- ticing more and more episodes of diar- rhea with red streaks. He sees his doctor, who orders testing for colorectal cancer. Question Which diagnostic test would be appropriate for James to help diagnose colorectal cancer? a. Proctoscopy. b. Sigmoidoscopy. c. Colonoscopy. d. Endoscopy. Answer/Rationale: The correct answer is c. A colonoscopy is preferable because this allows for visualization of the entire large bowel. Colorectal cancer is common and ac- counts for approximately 8% of all can- cer-related deaths in the U.S. (Macrae, 2022a). The incidence of colorectal can- cer has decreased annually with the screening process and technological ad- vances. It is currently estimated that ap- proximately 4% of the population will de- velop colorectal cancer in their lifetime, with adenocarcinoma being the most common, in approximately 95% of cases (Markman, 2022). Colorectal cancer gen - erally develops slowly and often remains
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